Despite medical advances across a wide range of diseases and conditions, the rate of complications during and after pregnancy remains high in the United States. According to the Centers for Disease Control and Prevention (CDC), hundreds of women die each year from pregnancy-related complications. An estimated 80% of complications are preventable. Even more alarming is that black women are three times more likely to die during pregnancy than white women.
“It’s an uncomfortable reality for many people and a sign that we have a much bigger problem when it comes to black maternal care,” says Mark-Robert Mahaga-Ajala, DO, obstetrician and gynecologist at Atlantic Health System. “Anytime we have health issues that affect a large number of women, the outcomes for black women are typically worse.”
Removing barriers to care
The high rate of complications for black women during pregnancy, childbirth and in the year after having a baby are the result of a constellation of factors, according to Dr. Mahaga-Ajala. The most concerning issue is racial bias in health care. Some providers may not have much experience caring for black women. This can cause misunderstandings when it comes to a patient’s personal, cultural or racial preferences.
“In many instances, black women don’t have the same access to quality health care as white women,” says Dr. Mahaga-Ajala. “There are social factors at play and many black women struggle to get the prenatal care they need to ensure a healthy pregnancy.”
Because of barriers to health care, black women often have higher rates of high blood pressure, preeclampsia and excessive bleeding after giving birth. Dr. Mahaga-Ajala says timely prenatal care to address medical concerns early is key to lowering the rate of life-threatening complications.
Building trust
Finding a physician who listens to your concerns, answers your questions and makes your health a priority is crucial, according to Dr. Mahaga-Ajala. In addition to working with a licensed obstetrician, many women choose to have a doula during their prenatal and postpartum journey. Because doulas often act as a coach and advocate, Dr. Mahaga-Ajala says many black women are choosing to have them participate in their pregnancy care.
“Evidence-based treatment is always the right answer when it comes to patient care,” says Dr. Mahaga-Ajala. “Patients should never be afraid to ask questions about their care plans, conditions or treatments. Understanding your health care is not a luxury, it’s a necessity.”
In addition to managing medical conditions such as diabetes or high blood pressure, Dr. Mahaga-Ajala encourages his patients to create a birth plan. He believes that spending time with your provider to discuss your hopes can ensure that everyone is on the same page for the big day. Working through your ideas for labor and delivery can help reduce anxiety and increase positive anticipation, as well as provide information about what is safe and possible in the delivery room.
“Having a frank and early conversation about what you want your childbirth experience to be like is an important part of building trust with your provider,” says Dr. Mahaga-Ajala. “As long as you hold your plan loosely and can let go of things if your situation changes, it allows us to work together during this watershed moment in your life.”
Dr. Mahaga-Ajala adds that understanding your health care needs, your treatment plan and advocating for yourself will give both mother and baby the best experience and outcome.
“Every woman deserves to have her voice heard,” says Dr. Mahaga-Ajala. “Having an advocate available, whether it’s your OB or a doula, who has expertise that matches your beliefs and expectations can make a huge difference.”
Be Proactive About Your Health
To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.